Revenue Cycle Management (RCM) Professionals – Federal Healthcare

Job Family:

Operational Effectiveness (ESA)

Travel Required:

Up to 10%

Clearance Required:

Ability to Obtain Public Trust

What You Will Do:

We are seeking experiencedRevenue Cycle Management (RCM) professionalsto support large-scale transformation initiatives within a Federal healthcare environment. These roles contribute to modernization efforts across enterprise electronic health record (EHR) platforms, includingOracle Health / MHS GENESIS, and support optimization of billing, coding, analytics, communications, and system workflows.

Candidates will collaborate with cross-functional stakeholders, develop high-quality deliverables, and drive improvements in revenue cycle performance, compliance, and operational efficiency.

Responsibilities are as follows, to include but not limited to:

Revenue Cycle Operations & Optimization

• Support end-to-end RCM functions including registration, coding, billing, claims, and reimbursement

• Analyze workflows and identify opportunities to reduce revenue leakage and improve efficiency

• Conduct charge capture validation and reconciliation between clinical and billing outputs

• Support Chargemaster (CDM) maintenance and optimization

System Configuration & EHR Support

• Assist in configuration, validation, and troubleshooting of EHR revenue cycle workflows (Oracle Health / Cerner / MHS GENESIS)

• Analyze billing rules, charge routing logic, and system integrations

• Partner with IT and configuration teams to resolve technical issues affecting claim generation and processing

Data Analysis & Reporting

• Analyze financial, clinical, and operational data to identify trends and improvement opportunities

• Develop dashboards, reports, and executive summaries using tools such as SQL, Power BI, Tableau, or similar

• Track key performance indicators (KPIs) across revenue cycle functions

• Perform data validation, quality checks, and root cause analysis

Claims & Denial Management

• Investigate claim edits, rejections, and denials

• Conduct root cause analysis related to coding, documentation, system configuration, or payer rules

• Recommend and implement corrective actions to improve first-pass payment rates

Compliance & Auditing

• Perform chart-to-bill audits ensuring accurate coding and documentation

• Ensure compliance with CPT, ICD-10, HCPCS, NCCI edits, and federal regulations (e.g., CMS, TRICARE, DHA)

• Support audit readiness and regulatory reporting requirements

Communication & Stakeholder Engagement

• Develop and deliver clear, concise communication products (presentations, reports, newsletters, briefings)

• Translate complex technical and operational information into stakeholder-friendly messaging

• Support leadership briefings, program updates, and change management communications

• Coordinate across teams to ensure consistent messaging and alignment

Change Management & Process Improvement

• Support implementation of system and workflow changes across the organization

• Develop communication and training materials to drive adoption

• Identify and implement process improvements to enhance performance and compliance

What You Will Need:

• Must be able to OBTAIN and MAINTAIN a Federal or DoD "PUBLIC TRUST"

• Bachelor’s degree; four (4) additional years of professional experience may be used in lieu of a degree.

• THREE (3) or more years of professional experience in revenue cycle management, healthcare consulting, or other relevant field

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What Would Be Nice To Have:

• Bachelor’s degree in Healthcare Administration, Business, Communications, Information Systems, or related field

• Experience with EHR systems (Oracle Health/Cerner, Epic, or similar), preferablyMHS GENESIS

• Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), and revenue cycle operations

• Experience analyzing data and developing reports or dashboards

• Excellent written and verbal communication skills

• Strong organizational skills with ability to manage multiple priorities

• Experience supporting Federal healthcare agencies (DoD, DHA, VA, or similar)

• Familiarity with Military Health System (MHS) operations

• Certifications such asPMP, CAPM, CPC, CCS, RHIT, or RHIA

• Experience with analytics tools (SQL, Power BI, Tableau, Python)

• Experience in large-scale healthcare transformation or EHR implementation programs

• Knowledge of healthcare data systems, reporting platforms, and interoperability

The annual salary range for this position is $61,000.00-$101,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave and Adoption Assistance

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Student Loan PayDown

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

• Mobility Stipend

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.